Cited by 235Maternal and Neonatal HealthcareMaternal Mental Health During Pregnancy and PostpartumGlobal Maternal and Child Health

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Integrated perinatal health framework

Misra, Dawn P, Guyer, Bernard, Allston, Adam·2003·American Journal of Preventive Medicine

DOI 10.1016/s0749-3797(03)00090-4

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Abstract

Background Despite great strides in improving prenatal care utilization among American women, key perinatal indicators have remained stagnant or worsened in the past decade, and the United States continues to rank near the bottom compared to other developed countries. A new approach is needed if we are to achieve improvements in perinatal health.Methods To propose a new framework that integrates a "life span" approach with a multiple determinants model.Results We recognize that (1) powerful influences on outcome occur long before pregnancy begins; (2) pregnancy outcome is shaped by social, psychological, behavioral, environmental, and biological forces; and (3) the demography of pregnancy has changed dramatically in the last few decades with more women delaying their first birth. Approaches that simultaneously consider the entire life span as well as multiple determinants may need to be adopted. We propose a framework that integrates these approaches and is supported by the research literature. The life span perspective focuses attention toward the preconceptional and interconceptional periods as targets for intervention in improving perinatal health. The multiple determinants model distinguishes among concepts of disease, health and functioning, and well-being for both women and their offspring.Conclusions Our intent is to influence how policymakers, public health professionals, clinicians, and researchers approach perinatal health.

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Authors: Misra, D. P., Guyer, B., & Allston, A.
Affiliations: Johns Hopkins University (US)
Corresponding author: Misra, Dawn P
ORCID: Misra, Dawn P
Allston, Adam
Venue: American Journal of Preventive Medicine
Publisher: Elsevier BV
Published: 2003-07
Volume: 25
Issue: 1
Pages: 65-75
ISSN: 0749-3797 (ISSN-L)
DOI: 10.1016/s0749-3797(03)00090-4
OpenAlex: W2105986652
Cited by: 235
References: 199
Citations by year: 2026: 6 · 2025: 7 · 2024: 6 · 2023: 10 · 2022: 9 · 2021: 8 · 2020: 9 · 2019: 15 · 2018: 13 · 2017: 17 · 2016: 11 · 2015: 14 · 2014: 13 · 2013: 14 · 2012: 13
FWCI: 9.92
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: American Journal of Preventive Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Public Health Service (U93 MC 00101)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Keywords: perinatal health, preconception care, pregnancy outcomes, social determinants of health, maternal health, child health, health policy framework
MeSH terms: Family Planning Services, Female, Health Promotion, Humans, Life Expectancy, Maternal Health Services, Maternal Welfare, Policy Making, Pregnancy, Pregnancy Outcome, United States, Preconception Care, Models, Organizational

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